Hands Off! New WHO Recommendations On Birth Intervention

It seems like common sense, but medical staff should not intervene in a woman’s labour, unless there are real complication risks, new guidance from the World Health Organisation (WHO) says.

Childbirth is a normal physiological process that most women and babies can accomplish without intervention. An estimated 140 million births take place around the world every year, most without any complication. But in recent years, with the increasing medicalization of birth, WHO says studies show a large proportion of healthy pregnant women undergo at least one needless and harmful clinical intervention during labour and birth, negatively impacting the mother’s birthing experience. Things such as introducing oxytocin to speed up labour, followed by an epidural for the pain, forceps/vacuum delivery or caesarean section.

WHO says studies show a large proportion of healthy pregnant women undergo at least one needless and harmful clinical intervention during labour and birth, negatively impacting the mother’s birthing experience.

The old advice was that birth should progress at a rate of 1 cm/hr of cervical dilation during the active first stage of labour, but WHO is now saying this is risky. These old guidelines “may be unrealistic for some women and is inaccurate in identifying women at risk of adverse birth outcomes,” they say.

The new WHO guideline recognizes that every labour and childbirth is unique and that the duration of the active first stage of labour varies from person to person and changes from first child to second child.

“If labour is progressing normally, and the woman and her baby are in good condition, they do not need to receive additional interventions to accelerate labour,” says Dr Princess Nothemba Simelela, WHO Assistant Director-General for Family, Women, Children and Adolescents.

Along with this, the new WHO guideline also includes 56 recommendations on what kind of care is needed throughout labour and immediately after for the mother and her baby.

Including:

having a companion of choice during labour and childbirth

ensuring respectful care and good communication between women and health providers

maintaining privacy and confidentiality

allowing women to make decisions about their pain management, labour and birth positions and natural urge to push